In breast clinics worldwide, cyclical mastalgia is the commonest presenting complaint among patients of reproductive age. Non-pharmacological options are preferred mode of treatment due to their better side effect profile. This study compares the effectiveness of two such non-pharmacological options i.e. Vitamin E and Evening Primrose Oil. Study Design: Randomized controlled single blinded trial. Setting: Surgical Unit 1 Holy Family Hospital, Rawalpindi. Period: Six months from July to Dec 2017. Materials and Methods: Observing all scientific and ethical protocols. All non-pregnant and non-lactating females of reproductive age were included in study. Two groups A and B, of 190 patients each, were made. Group A received Vitamin E capsules 400 mg once daily whereas group B received evening primrose oil 500 mg capsules twice daily. After six months, mean reduction in pain scores in both groups was calculated using a t-test (p-value < 0.05 was considered significant). Results: Total number of 380 female patients (190 in each group) were enrolled in study for a period of 6 months. Mean age was 30.00+16.54 years. Mean score at presentation was 5.69+0.08 in vitamin E group and 5.66+0.8 in EPO group. After 6 months, score was 3.70+1.5 in vitamin E group and 4.78+1.47 in EPO group, which was statistically significant (p value < 0.05). Conclusion: Vitamin E, when taken for 6 months, is more effective than evening primrose oil in reducing pain in moderate cyclical mastalgia.

Background: Urinary tract infections (UTIs) are very communal, and patients with diabetics develop UTIs more frequently. Acute kidney injury (AKI) can be a complication of UTI. This study is designed to determine whether Urinary tract infections because of extended-spectrum beta-lactamase (ESBL) could be a risk factor of acute kidney injury in individuals with type-II diabetes mellitus. Methods: This case study was conducted in the Outpatient department of Diabetes Hospital Peshawar and Nishter Hospital Multan for duration of six months from August 2020 to January 2021. People of type II diabetes were assessed with culture confirmed UTI. The cases of UTI patients complicated with AKI were included in the study group, and people without AKI were taken as a control group. ESBLs positivity from isolated organisms have been assessed as risk factors for AKI. A total of 140 subjects were selected with equal distribution in two groups. The group A has UTI complicated with AKI and group B included has patients without AKI but with UTI. Results: UTI was diagnosed in 140 cases among type-II diabetic patients with 2:4 male to female ratio. The duration and mean age of diabetes mellitus were 8.60±5.35and55.80±14.10 years, correspondingly. The strongest common etiological factor was Escherichia coli (60.7%), trailed by Klebsiella pneumoniae (11.4%). In ESBL positive organism; E. coli was present in 81.4% and K. pneumoniae in 10% of individuals. Of the 140 UTI cases, AKI was observed in 70 (50%); out of which 48 (62.5%) were ESBL-positive microorganisms and 22 (22/70, 31.43%) for non-ESBL microorganisms. Conclusions: Nearly50% of the patients with type-II diabetes mellitus and UTI had ESBL-positive microorganisms as etiological mediators in this analysis. Owing to the presence of ESBL-positive microorganisms, UTI was the main cause of AKI and is a strong risk factor. Keywords: ESBL, Acute kidney injury, UTI, type 2 diabetes, risk factor.

Breast cancer is an abnormal division of breast cells. Bisphenol A (BPA), an environmental toxicant is identified as an emerging risk factor for breast cancer development. However, to the best of our knowledge no previous study has investigated the BPA levels in breast cancer patients in Pakistan. The present study sought to explore the role of BPA in tumor growth among the Pakistani population. As an endocrine disrupting chemical (EDC), BPA has greater potential to initiate tumorigenic events in breast tissue by the generation of oxidative stress. The level of BPA in the serum samples of breast cancer patients was significantly (p ≤ 0.01) high as compared to normal control. Histological analysis of breast cancer tissue samples revealed distinct subtypes of tumor such as ductal carcinoma in situ (DCIS)) and invasive ductal carcinoma (IDC). There was a significant (p ≤ 0.01) increase in ROS level while significant (p ≤ 0.01) decrease in the levels of superoxide dismutase (SOD) and catalase (CAT) enzymes in malignant breast tissue samples as compared to normal tissue samples. We found upregulated expression of p53, ZEB1 and WNT1 genes at mRNA level in malignant breast tissue samples by 17 folds, 328 folds and 35 folds respectively. p53 protein expression in malignant breast tissue samples was also enhanced at the translational level. Conclusively, the current findings suggest a relationship between BPA and the progression of breast cancer among the Pakistani population.

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